Monday, November 7, 2011

Chickenpox Lollipops, Chickenpox Parties

Chickenpox lollipops? According to media reports, parents who fear the chickenpox vaccine can try to infect their kids the “natural” way by sending off for lollipops licked by kids who have the disease. Apparently, the infected kids’ spit is also available.

Perhaps because sending infectious diseases by mail is a federal crime, those internet offers have become hard to find. But even if it weren’t a crime, it would be both dangerous and irresponsible.

First, a couple of facts. The chickenpox vaccine keeps kids from getting the chickenpox virus. Chickenpox is a herpes virus. And like other herpes viruses, infection is lifelong. True, once you’re infected you’ll never again get chickenpox. But if and when the virus re-emerges, it causes the extremely painful disease known as shingles.

Vaccinated kids have a lower risk of shingles than do unvaccinated kids, or kids who get natural chickenpox infections, according to William Schaffner, MD, president of the National Foundation for Infectious Diseases and chair of the department of preventive medicine at Vanderbilt University, Nashville, Tenn.

Here’s the transcript of a talk I had with Dr. Schaffner this morning. Well, Dr. Schaffner talked, and I listened. My part of the conversation was to ask what he thinks of the idea of skipping the chickenpox vaccine and buying your kid a lollipop licked by a chickenpox patient.

Dr. Schaffner:
“First of all, there is nothing good to be said about this. It is a totally misinformed concept.

“Might someone actually acquire chickenpox from a lollipop, spit, or a similar substance through the mail? This is very unlikely to be successful.

“Chickenpox is not spread through oral secretions but by the respiratory route. You have to inhale this virus for it to be successful. It’s spread through sneezing or couching or just breathing out the virus. You can actually excrete the virus the day before you are sick.

“But on that lollipop and in the spit or whatever other substance, there are going to be other germs. No doubt about it: bacteria and possibly viruses. So you are spreading something else, such as perhaps staph infection, that you don’t intend to spread, and you have no idea of what the consequences are.

“The recipient does not know much about the sender. Even if the sender is an upright, nice person, microbes ignore that.

“But suppose it would work, or that you take your child to a chickenpox party, your child gets chickenpox. Several things are noteworthy.

“First, there is the worst-case scenario. I am sure these well intended moms are not aware of chickenpox encephalitis or chickenpox pneumonia. Those are the worst features of chickenpox, and you cannot predict who will get those awful infections.

“If you got the lollipop and gave to your daughter or son and they became semi-comatose and had to be admitted to intensive care, you would never forgive yourself. Chickenpox encephalitis is not common. But it is a risk. And chickenpox pneumonia: You would not want anyone to have that.

“The second thing is chickenpox is a communicable disease. If you infect your child with chickenpox, that child can spread it to others. So you are putting other people in your community — playmates, schoolmates, someone in the mall – at risk of chickenpox.

“Now these moms are going to say that everyone else has had the chickenpox vaccine, so they are protected and not at risk. Wrong. Why is that wrong?

“Increasingly among us are people who are too ill, too frail, who are immune compromised, who have cancer, or other diseases. If your child spreads chicken pox to them, they can literally become gravely ill — and I meant that in the root sense of the word. It can be mortally fatal.

“So by creating an infection in your child you are disregarding the safety of others. By being protected ourselves, we protect these increasing numbers of people whom medical science permits to leave nearly normal lives even with impaired immune systems.

“By creating an infection in your child, you put others at risk. That is irresponsible and selfish. You are not cognizant of the risk you are creating for others. And that in my opinion is also part of your responsibility as a citizen.

“All of these things pertain to chickenpox parties. And every pediatrician in the country will tell you it is a bad idea. You cannot predict who is going to get very serious infections. Mothers can be very blithe about this because they have not seen these serious infections and don’t know they are putting their child at risk.

“And there is one more minor, almost trivial consequence of chickenpox. It is a pox infection. That means when it heals it can leave scars. My daughter had chickenpox before the vaccine was available. She had a few scars on her face, and she did not like them. That is trivial, cosmetic, but would you do this to your daughter — who would point out forever it was you who did this to her face? My daughter rued the fact that she had those scars, although they did not affect her life.”

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